A retrospective analysis of the impact of treatments and blood counts on survival and the risk of vascular events during the course of polycythaemia vera
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Media type:
E-Article
Title:
A retrospective analysis of the impact of treatments and blood counts on survival and the risk of vascular events during the course of polycythaemia vera
Description:
<jats:title>Summary</jats:title><jats:p>Vascular and non‐vascular complications are common in patients with polycythaemia vera. This retrospective study of 217 patients with polycythaemia vera aimed to determine whether blood counts with respect to different treatments influenced the complication rate and survival. We found that 78 (36%) patients suffered from at least one complication during follow‐up. Older age and elevated lactate dehydrogenase at diagnosis were found to be risk factors for vascular complications. When the vascular complication occurred, 41% of the patients with a complication had elevated white blood cells (<jats:styled-content style="fixed-case">WBC</jats:styled-content>) compared with 20% of patients without a complication (<jats:italic>P</jats:italic> = 0·042). Patients treated with hydroxycarbamide (<jats:styled-content style="fixed-case">HC</jats:styled-content>; also termed hydroxyurea) experienced significantly fewer vascular complications (11%) than patients treated with phlebotomy only (27%) (<jats:italic>P</jats:italic> = 0·013). We also found a survival advantage for patients treated with <jats:styled-content style="fixed-case">HC</jats:styled-content>, when adjusted for age, gender and time period of diagnosis (Hazard ratio for phlebotomy‐treated patients compared to <jats:styled-content style="fixed-case">HC</jats:styled-content>‐treated patients at 5 years was 2·42, 95% confidence interval 1·03‐5·72, <jats:italic>P</jats:italic> = 0·043). Concerning survival and vascular complications, <jats:styled-content style="fixed-case">HC</jats:styled-content>‐treated patients who needed at least one phlebotomy per year were not significantly different from <jats:styled-content style="fixed-case">HC</jats:styled-content>‐treated patients with a low phlebotomy requirement. We conclude that complementary phlebotomy in <jats:styled-content style="fixed-case">HC</jats:styled-content>‐treated patients in order to maintain the haematocrit, is safe.</jats:p>